This article presents a brief summary of the health of children in Australia. Topics covered include health conditions, mental health, disability, risk factors and mortality. The article also describes how some factors influencing children's health are changing over time.

DATA SOURCES

Unless otherwise stated, information for this article is drawn from the 2004-05 National Health Survey (NHS). Other data sources include the 2001 NHS, 2004-05 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS), 2003 Survey of Disability Ageing and Carers (SDAC) and administrative data collections on mortality and hospitalisation. This article generally focuses on the health characteristics of children aged under 15 years. Consistent with ABS survey practice, information about the long-term health conditions of children of this age is collected in the NHS from an adult in the household, usually the child's parent.

INQUIRIES

For further information about these and related statistics, contact the National Information and Referral Service on 1300 135 070 or email client.services@abs.gov.au.

THE HEALTH OF CHILDREN

In June 2006, there were 4 million children aged under 15 years in Australia, representing one-fifth (19%) of the total population (ABS 2006a). Health gains brought about by better living conditions, education, medical care and vaccination would suggest that this generation of children should be the healthiest ever (Patton et al. 2005). However, there are emerging concerns related to rapid social change and the associated new morbidities such as increasing levels of behavioural, developmental, mental health and social problems (AIHW 2006). Early childhood in particular has become a key priority for Australian government and non-government organisations (AIHW 2006).

HEALTH CONDITIONS

In 2004-05, 41% of children aged under 15 years had a long-term health condition compared with 44% in 2001(footnote 1)(ABS 2006 & ABS 2002).

Boys (44%) were more likely than girls (38%) to have a long term health condition.

Diseases of the respiratory system were reported for 19% of children - the main conditions were asthma (12%), hayfever and allergic rhinitis (8%) and chronic sinusitis (3%) (footnote 2).

Diseases of the eye and adnexa were reported for 10% of children - the main conditions were long sightedness (4%) and short sightedness (4%).

Mental and behavioural problems were reported for 7% of children overall - these main conditions were behavioural & emotional problems with usual onset in childhood or adolescence (3%) and problems of psychological development (3%).

Asthma

In 2004-05, one in eight children aged under 15 years (12%) were reported as having asthma as a long-term health condition, which was similar to the rate in 2001 (ABS 2006 & ABS 2002).

Among children aged under 15 years, rates of asthma were 13% for boys and 10% for girls.

Higher rates of asthma were reported for children aged five years and over than for children aged under five years.

Asthma by age and sex, 2004-05

Diabetes

The impact of diabetes on children's health is often severe, both during childhood and later in life (footnote 3)(AIHW 2006).

In 2004-05, less than 0.2% of children aged under 15 years were reported as having diabetes as a long term health condition(footnote 4).

In 2004, 982 new cases of Type 1 diabetes were recorded in children aged under 15 years, which equates to an annual incidence of 24.6 per 100,000 population (around 1 in 4,000) in that age group (footnote 5)(AIHW 2006).

Previous state-based estimates of the incidence of Type 1 diabetes in children have ranged from 12.3 per 100,000 in 1983 to 23.2 in 2002 (AIHW 2006).

Mental health

According to the 1998 Child and Adolescent Component of the National Survey of Mental Health and Wellbeing, 14% of young people aged 4-17 years were reported to have a mental health problem (Sawyer et al. 2000) .

There was a strong association found between mental health problems and certain demographic factors, with high rates of mental health problems among children and adolescents living in low-income, step/blended and one-parent families (Sawyer et al. 2000).

In 2004-05, 7% of children aged under 15 years were reported to have some form of mental or behavioural problem as a long-term health condition, with rates rising from very low levels among children aged under five years to 10% of children aged 10-14 years.

Injury

Preventable injuries are higher amongst children compared with other age groups. In 2004 the Australian government identified injuries in children aged 0-14 as a priority issue (AIHW 2006).

In 2004-05, 25% of children aged 0 -14 years had experienced an injury during the four weeks prior to the NHS interview that required professional assistance, treatment or reduced their usual activity.

Of children who experienced a recent injury, the most common causes were falling from a low height - one metre or less (43%), hitting something or being hit by something (14%), or being bitten or stung (13%).

MORTALITY

Death rates for both infants (aged under one year) and children (aged 1-14 years) have fallen in recent decades and continue to fall (AIHW 2006).

Between 1984 and 2003 the death rate for Australian children aged 1-14 years decreased from 30 to 15 deaths per 100,000 children (AIHW 2006).

Most childhood deaths (68% in 2004) occurred in the first year of life, with 15% among those aged 1-4 years and the remaining 17% in the 5-14 years age group (AIHW 2006).

Infant mortality (less than one year of age)

During the period 2002-2004 an average of 1,200 infant deaths occurred in Australia each year (ABS 2006b).

In 2005, the death rate for neonatal deaths (deaths within the first four weeks of life) was 3.6 per 1,000 live births, and 1.4 per 1,000 live births for post-neonatal infant deaths (deaths after 28 days and before one year of life) (ABS 2006b) (footnote 6).

Of neonatal deaths, 55% were male and 45% were female, while of post-neonatal deaths, 54% were male and 46% were female (ABS 2006b).

In 2004, certain conditions originating in the perinatal period (the period five months before or one month after birth) accounted for 47% of total infant deaths while congenital malformations, deformations and chromosomal abnormalities accounted for 24% (footnote 7) (ABS 2006c).

In 2004, there were 569 deaths of children aged 1-14 years. The death rate for children was 15 per 100,000 children (footnote 8) (ABS 2006c).

Of the total deaths of children aged 1-14 years, 60% were male and 40% were female resulting in death rates of 18 per 100,000 boys and 13 per 100,000 girls, respectively (ABS 2006c).

The difference between death rates for boys and girls aged 1-14 years has been decreasing since the 1980s (AIHW 2005a).

The major causes of death in children were from external causes (36%), cancer (19%), and diseases of the nervous system (11%) (ABS 2006c).

External causes of death among children included traffic accidents (15% of total deaths) and accidental drowning (7% of total deaths) (ABS 2006c).

Assault accounted for 9% of childhood deaths between 1999 and 2003 (128 childhood deaths). Of these deaths, two thirds (65%) occurred for children aged under five years (ABS 2005a).

Major causes of mortality among children aged 1-14 years, 2004

DISABILITY

In 2003, 319,900 children aged under 15 years (8%) reported a disability (footnote 9) (ABS 2004).

Among children with a disability, 62% were boys and 38% were girls (ABS 2004).

In 2003, 4% of children aged under five years and 10% of children aged 5-14 years had a disability (ABS 2004).

Of those with a disability, 67% of children aged under five years and 49% of those aged 5-14 years had a profound or severe core activity limitation(footnote 10) (ABS 2004).

Disability by age and sex, 2003

INFANT HEALTH

Immunisation

There has been a trend of increasing vaccination coverage over time for children aged one, two and six years (footnote 11). However, the rate of increase has slowed over the past three years, especially for children aged one and two years (AIHW 2006).

As at 31 December 2005, vaccination coverage for Australian children at age one year was 91% and covered diphtheria, tetanus, whooping cough, poliomyelitis, measles, mumps, rubella, Haemiphilus influenza (Hib) and hepatitis B (AIHW 2006).

Correspondingly, the proportion of children fully vaccinated at age two years was 92% and at age six years it was 84% (AIHW 2006).

Breastfeeding

Breastfeeding has a positive impact on the growth, development and health of an infant (AIHW 2006).

Of children aged up to three years in 2004-05, 88% had at some stage obtained nutrition from breastmilk, which was similar to the rate (87%) in 2001 (ABS 2006 & ABS 2002).

In 2004-05 (at the time of the NHS interview), of infants aged up to three months, 67% were currently being breastfed while for infants aged 4-6 months 52% were currently being breastfed (footnote 12).

LIFESTYLE RISK FACTORS

The 2004 NSW Schools Physical Activity and Nutrition Survey (SPANS) showed that 26% of boys and 24% of girls in NSW aged approximately 5-16 years were overweight or obese, compared with 11% of all young people aged 7-16 years in 1985 (COO 2006).

The 2004 SPANS found that there has been a recent increase in the proportion of children who fulfil the exercise requirements of moderate to vigorous physical activity according to the Australian Physical Activity Recommendations for Children and Young People (DoHA 2005). Nevertheless, the level of sedentary behaviour for children is still high. (COO 2006) (footnote 13).

In the 12 months to April 2006, 63% of children aged 5-14 years participated in sport, outside of school hours, which had been organised by a school, club or association. This was an increase of two percentage points in the rate of participation from 2003 (ABS 2006d).

Children spent an average of 20 hours over a school fortnight in the 12 months to April 2006 watching television, videos or DVDs and also spent an average of eight hours playing electronic or computer games (ABS 2006d).

HOSPITALISATION

Of total hospital separations (footnote 14) in 2004-05, 528,100 (8%) involved children aged under 15 years (AIHW 2007).

Certain conditions originating in the perinatal period (38%) and diseases of the respiratory system (13%) were the main causes of hospitalisation for children under one year of age(AIHW 2007).

Respiratory disease (25%) and injury (12%) were the main causes of hospitalisation of children aged 1-14 years (AIHW 2007).

Rates of hospitalisation due to respiratory disease fell from 25% of children aged 1-4 years to 18% of children aged 5-9 years and 10% of children aged 10-14 years (AIHW 2007).

Among children, rates of hospitalisation due to injury increased with age and were higher for boys than for girls (ABS 2005a).

Other leading causes for hospitalisation among children included disorders related to short gestation and low birthweight (for children aged under five years) and chronic diseases of tonsils and adenoids (AIHW 2006).

Major reasons for hospital separations for children aged 1-14 years, 2004-05

INDIGENOUS CHILDREN

In 2004-05, 44% of Indigenous children aged under 15 years were reported to have at least one type of long term health condition, which was not significantly different from the corresponding rate for non-Indigenous children (41%)(ABS 2006e).

The most common long term health conditions among Indigenous children were diseases of the respiratory system (19%), diseases of the ear and mastoid (10%), and diseases of the eye and adnexa (8%) (ABS 2006e).

The prevalence of ear/hearing problems, including total/partial hearing loss and otitis media (middle ear infection), was three times higher among Indigenous than non-Indigenous children (ABS 2006e).

Between 1999 and 2003, mortality rates for Indigenous infants were nearly three times higher than those for other Australian infants (AIHW 2006).

According to data combined from Queensland, Western Australia, South Australia and the Northern Territory, in 1999-2003, the death rate for Indigenous children aged 1-14 years was 39 per 100,000 children, compared with 16 deaths per 100,000 among other Australian children (AIHW 2006).

According to the 2000-02 National Perinatal Data Collection, babies of Indigenous mothers were twice as likely as those born to non-Indigenous mothers to have low birthweight (13% compared with 6%) (AIHW 2005b).

In 2004-05, nine in ten Indigenous children who were aged under seven years and living in non-remote areas were reported as being vaccinated against diphtheria, tetanus, whooping cough, polio, hepatitis B, measles, mumps, rubella and haemophiles influenza type B (ABS 2006e).

In 2003-04, Indigenous infants aged less than one year were hospitalised at a rate that was one-and-one-thirds higher than that for non-Indigenous infants while among children aged 1-14 years, rates of hospitalisation were similar for most conditions regardless of Indigenous status (ABS 2005b).

Diseases of the respiratory system was the most common reason for hospitalisation for both Indigenous and non-Indigenous children aged 1-14 years (ABS 2005b).

FOOTNOTES

1. A long term health condition is a current condition which has lasted or is expected to last for six months or more. < Back

2. People may have more than one long term health condition, therefore the same child may be represented in more than one condition category. < Back

3. Type 1 diabetes is characterised by a complete or near complete lack of insulin that usually occurs before the age of 40 years and accounts for the vast majority of diabetes cases in children. People with Type 2 diabetes have insulin but this is reduced in its effect. Although the onset of Type 2 diabetes usually occurs over the age of 40 years, it is now affecting children (AIHW 2006). < Back

4.This estimate has a relative standard error of between 25% to 50% and should be used with caution. < Back

5. Incidence refers to the number of new cases of an illness or event occurring during a given period, whereas prevalence refers to the number or proportion of cases or instances present in a population at a given time (AIHW 2006). The estimate of the number of new cases of diabetes in 2004 is a measure of incidence while the estimate of the number of children reported as having diabetes (or any other condition) in the 2004-05 NHS is a measure of prevalence. < Back

6. The infant mortality rate is defined as the number of deaths among infants less than one year of age in a given year expressed per 1,000 live births in the same year. < Back

7. Certain conditions originating in the perinatal period include: Foetus and newborn affected by maternal factors and by complications of pregnancy, labour and delivery; Disorders related to length of gestation and foetal growth; Birth trauma; Respiratory and cardiovascular disorders specific to the perinatal period; Infections specific to the perinatal period; Haemorrhagic and haematological disorders of foetus and newborn; Transitory endocrine and metabolic disorders specific to foetus and newborn; Digestive system disorders of foetus and newborn; Conditions involving the integument and temperature regulation of foetus and newborn; and Other disorders originating in the perinatal period. < Back

8. The child mortality indicator is defined as the number of deaths of children aged 1-14 years of age per 100,000 children of the same age group. < Back

9. Disability refers to the presence of any limitation, restriction or impairment which has lasted, or is likely to last, for at least six months and restricts everyday activities (ABS 2004).< Back

10. A core-activity limitation comprises mobility, communication and self-care. A person with a profound core activity limitation is unable to perform or always needs help with a core activity task and a person with a severe core activity limitation sometimes needs help with a core activity task (ABS 2004). < Back

11. Vaccination coverage refers to the level of age-appropriate vaccination in the population. A child is fully vaccinated if he or she has received all the vaccinations appropriate to his or her age in accordance with the National Immunisation Program Schedule (AIHW 2006). < Back

13. The Australian Physical Activity Guidelines for Children and Youth aged 5-18 years recommend that students spend at least an hour participating in moderate to vigorous physical activity (MVPA) every day. They also recommend that children should not spend more than two hours per day playing computer games, watching television or using the internet for entertainment. < Back

14. A hospital separation is a completed episode of care in a hospital. < Back

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